Healthcare Provider Details

I. General information

NPI: 1912416058
Provider Name (Legal Business Name): BETSY MEIER COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2017
Last Update Date: 09/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 COLLEGE AVE SE
GRAND RAPIDS MI
49503-5921
US

IV. Provider business mailing address

PO BOX 10
MASON MI
48854-0010
US

V. Phone/Fax

Practice location:
  • Phone: 269-650-2136
  • Fax: 616-635-2918
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801096209
License Number StateMI

VIII. Authorized Official

Name: MRS. MARY BETH HOUPT
Title or Position: CREDENTIALING
Credential:
Phone: 517-676-9788